Because the oyster has expelled the implanted nucleus of the pearl, the resulting Keshi pearl is 100% nacre. This gives it an especially lustrous and shimmering surface quality. Most Keshi, in fact, have a greater luster than even the best quality cultured pearls.

Today Keshi pearls are much more rare. This is because Tahitian and South Sea pearl farms are now x-raying oysters to determine whether or not the nucleus has been expelled. When a nucleus-free oyster is found they are then re nucleated before a Keshi has time to form. This practice has made Keshi pearls much more of a rare find than they once used to be.

In China, pearl was used to treat heart palpitations, high blood pressure, said to stimulate imagination and help with decision-making. It is also used as a symbol of faith and innocence.